Self-Service Search for TiC Negotiated Rates by NPI and Billing Code

Yes. Gigasheet's Price Transparency Explorer is a self-service tool for searching published Transparency in Coverage negotiated rates by NPI, payer, billing code, and market, nationwide. It runs on the same normalized data behind Gigasheet's API and bulk licenses, so analysts get answers on their own instead of waiting on a data team or parsing multi-gigabyte JSON. To look inside one raw file, the MRF Viewer opens it in your browser.

Is there a self-service tool to search TiC negotiated rates by NPI and billing code?

Yes. Gigasheet's price transparency data can be searched by organization, NPI, EIN, billing code, or taxonomy code, then narrowed by payer and market. You run the search yourself. Gigasheet has already done the parsing, cleaning, and normalization.

A search returns:

• The negotiated rate and its rate type.
• The payer, with plan and network where the file publishes them.
• The provider, with NPI, organization, and specialty.
• The billing code, including CPT, HCPCS, and DRG codes as published.
• Market context: how the rate compares with other providers in the same market, plus a Medicare comparison.

Smart Rate automatically excludes outliers and non-comparable rates, and Provider Rate Scores show where a rate sits in its local market.

Want to try it on one provider first? Enter a 10-digit NPI in the public rate preview to see negotiated rates nationwide and how that provider compares with its local market.

What are Transparency in Coverage machine-readable files?

Transparency in Coverage machine-readable files are public payer files that disclose pricing information, including in-network rates for covered items and services. According to CMS, most group health plans and issuers must post them on a public website.

They are public, but they were built for machines, not analysts. CMS itself notes that specific technology may be needed to download and read them given their size and complexity. A single payer can publish thousands of files, and rates for one provider can be spread across many of them.

The rules are changing. In October 2026, CMS finalized new Transparency in Coverage rules. Plans will publish one in-network rate file per provider network instead of per plan, add taxonomy and utilization files, and move in-network rate files from monthly to quarterly updates starting in the second year of implementation. See our breakdown of what changed and why it matters.

Which TiC file contains in-network negotiated rates?

The in-network rate file. It discloses in-network rates for covered items and services, per CMS. Do not confuse it with the other price transparency files:

• TiC in-network rate file: published by the health plan or insurer. Contains in-network negotiated rates. Use it for payer-provider contract-rate analysis.
• TiC out-of-network allowed amount file: published by the health plan or insurer. Contains allowed amounts and billed charges for out-of-network providers. Not contract rates.
• Hospital price transparency file: published by the hospital. Contains the hospital's standard charges, including gross charges, payer-specific negotiated charges, and the discounted cash price, as defined in 45 CFR 180.20. Use it for hospital pricing analysis.

Payer files show one payer's contracts across many providers, including physicians. Hospital files show one hospital's contracts across many payers. Gigasheet brings both into the same search.

How does Gigasheet make TiC data searchable?

Gigasheet prepares published payer and hospital files for filtering, comparison, and analysis, so your team does not have to build and maintain its own data pipeline.

1. Search. Start with a provider, NPI, EIN, payer, market, or billing code.
2. Review the records. See matching negotiated rates with payer, plan, network, and provider detail.
3. Compare. Line rates up across providers, payers, plans, procedures, geography, network, and site of care, with Medicare as a reference point.
4. Take it with you. Export results to CSV, pull them through the API, or license the full dataset for your own warehouse.

Data source and update context: the negotiated-rate data comes from payer Transparency in Coverage machine-readable files and hospital price transparency files. Under the current rules, CMS requires applicable plans to post their files monthly. Every record keeps lineage back to the source file.

When should you open a raw MRF instead?

When you need to see exactly what one file says. Gigasheet's MRF Viewer opens JSON or CSV files at a billion rows and beyond in your browser, flattened and searchable, with no local storage, ETL, or code.

• Good for: checking one rate, one provider, one billing code, or how a file is structured. Export only the rows you need to CSV.
• Not for: payer analysis at scale. One file is one slice of one payer. For cross-payer and cross-provider comparisons, use the Price Transparency Explorer, which already has the files parsed and normalized.

For a walkthrough, see our guide to opening and viewing machine-readable files.

What can you analyze with negotiated-rate data?

Negotiated-rate data supports rate benchmarking, payer contract analysis, market comparisons, and network research.

• Providers and MSOs: compare reimbursement by billing code and market before payer negotiations. See how providers use price transparency data in payer negotiations.
• TPAs, self-insured employers, and benefits consultants: compare plan and network pricing.
• Payment integrity, repricing, and cost-containment teams: measure rate variation across payer and provider combinations.
• Healthcare technology and data companies: license the data or build on the API.

What should you check before using a negotiated rate?

A published negotiated rate is a contract term, not a price tag. Before you rely on one:

• It is not a patient price. It is not an out-of-pocket cost, a cash price, or a guaranteed payment.
• It applies to a specific plan and network. The same provider can have different rates with the same payer across networks.
• Check the rate type. Dollar amounts and percentage-based arrangements do not belong in the same calculation.
• Check the setting. Professional and facility rates for the same code are separate payments.
• Check the file date. Rates change as contracts renew and files refresh.

For the full method, see our guides to comparing insurer negotiated rates and finding the median commercial rate.

How do you get started?

• Look up a provider: enter an NPI in the public rate preview to see negotiated rates nationwide.
• See the workflow: watch the Transparency in Coverage demo.
• Go deeper: Request a Demo for the full Price Transparency Explorer, API access, or bulk data licensing.

Last updated November 5, 2026.